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Nosocomial transmission of influenza: A retrospective cross-sectional study using next generation sequencing at a hospital in England (2012-2014)

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  • Nosocomial transmission of influenza: A retrospective cross-sectional study using next generation sequencing at a hospital in England (2012-2014)

    Influenza Other Respir Viruses. 2019 Sep 19. doi: 10.1111/irv.12679. [Epub ahead of print]
    Nosocomial transmission of influenza: A retrospective cross-sectional study using next generation sequencing at a hospital in England (2012-2014).

    Blackburn RM1, Frampton D2, Smith CM1, Fragaszy EB1,3, Watson SJ4, Ferns RB5, Binter ?4, Coen PG6, Grant P5, Shallcross LJ1, Kozlakidis Z1,7, Pillay D2,8, Kellam P4, Hu? S3, Nastouli E5,9, Hayward AC10; ICONIC group.
    Collaborators (10)

    Author information

    1 Institute of Health Informatics, UCL, London, UK. 2 Division of Infection and Immunity, UCL, London, UK. 3 Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. 4 Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, UK. 5 Clinical Microbiology and Virology, University College London Hospitals NHS Foundation Trust, London, UK. 6 Infection Control Department, University College London Hospitals, NHS Foundation Trust, London, UK. 7 International Agency for Research on Cancer, World Health Organization, Lyon, France. 8 Africa Health Research Institute, Durban, South Africa. 9 Department of Population, Policy and Practice, UCL Institute of Child Health, London, UK. 10 Institute of Epidemiology and Health Care, UCL, London, UK.

    Abstract

    BACKGROUND:

    The extent of transmission of influenza in hospital settings is poorly understood. Next generation sequencing may improve this by providing information on the genetic relatedness of viral strains.
    OBJECTIVES:

    We aimed to apply next generation sequencing to describe transmission in hospital and compare with methods based on routinely-collected data.
    METHODS:

    All influenza samples taken through routine care from patients at University College London Hospitals NHS Foundation Trust (September 2012 to March 2014) were included. We conducted Illumina sequencing and identified genetic clusters. We compared nosocomial transmission estimates defined using classical methods (based on time from admission to sample) and genetic clustering. We identified pairs of cases with space-time links and assessed genetic relatedness.
    RESULTS:

    We sequenced influenza sampled from 214 patients. There were 180 unique genetic strains, 16 (8.8%) of which seeded a new transmission chain. Nosocomial transmission was indicated for 32 (15.0%) cases using the classical definition and 34 (15.8%) based on genetic clustering. Of the 50 patients in a genetic cluster, 11 (22.0%) had known space-time links with other cases in the same cluster. Genetic distances between pairs of cases with space-time links were lower than for pairs without spatial links (P < .001).
    CONCLUSIONS:

    Genetic data confirmed that nosocomial transmission contributes significantly to the hospital burden of influenza and elucidated transmission chains. Prospective next generation sequencing could support outbreak investigations and monitor the impact of infection and control measures.
    ? 2019 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.


    KEYWORDS:

    cross infection; disease outbreaks; human; influenza; molecular epidemiology

    PMID: 31536169 DOI: 10.1111/irv.12679
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